The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Residential Treatment Facility, Physical Disabilities Primary Specialty

NUCC Taxonomy Code: 320700000X

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

NUCC Taxonomy Code: 320600000X

License # reported to NPPES AK 938082

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Alaska State Medical Licensing Board.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events

✅

NPI Profile Active February 07, 2018

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address February 07, 2018

Registered at 1010 W 29TH PL, ANCHORAGE, AK 995033744 (Tel: 9072230251)

📍

Updated Practice Location February 07, 2018

Registered at 1493 MOSS CREEK AVE, ANCHORAGE, AK 995073800 (Tel: 9079295620)

👤

Provider Name / Credentials Updated February 07, 2018

Recorded as MAM JALLOW

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2018

Residential Treatment Facility, Intellectual and/or Developmental Disabilities (license number reported to NPPES: AK 938082)

✅

NPI Profile Active May 18, 2010

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) May 18, 2010

Registered at 1493 MOSS CREEK AVE, ANCHORAGE, AK 995073800 (Tel: 9079295620)

📍

Business Mailing Address (Initial Record) May 18, 2010

Registered at 1493 MOSS CREEK AVE, ANCHORAGE, AK 995073800 (Tel: 9079295620)

👤

Provider Name / Credentials (Initial Record) May 18, 2010

Recorded as MAM JALLOW

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2010

Residential Treatment Facility, Intellectual and/or Developmental Disabilities (license number reported to NPPES: AK 938082)

🟢

Initial NPI Registration & Enumeration January 12, 2010

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1225368335

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 12, 2010

Last Update: February 07, 2018

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1010 W 29th Pl

Anchorage, AK 995033744

Phone: 9072230251

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.